Government to organise stakeholders’ forum on health insurance

Government is to hold a national stakeholders forum to find sustained solutions to the National Health Insurance Scheme (NHIS), Minister of Health, Mr. Kwaku Agyemang-Manu, has announced.

“It’s our priority now to do what we can do best to see what solutions we can bring on,”’ the minister assured the House and the nation last Tuesday, as he wrapped up on the debate on the motion to approve the National Health Insurance Fund Allocation Formula for 2017.

The House approved the formula for the distribution for the year 2017.

The object of the National Health Insurance Authority under Act 852 is to attain universal health Insurance coverage in relation to persons resident in Ghana, and non-residents visiting Ghana, and to provide access to healthcare services to the persons covered by the scheme.

Section 39 of ACT 852 established the National Health Insurance Fund and the object of the Fund is to pay for the healthcare services of members of National Health Insurance Scheme (NHIS).

One of the main challenges of the scheme is the funding gap receipts and expenditures, and it is expected that participants at the forum would make recommendations on how to rake in funds to sustain the scheme.

A dossier on the Formula made available in Parliament said the strategic intent of the Authority as captured in the Medium Term Strategic Plan 2015-2018 was to consolidate the position of the NHIS as preferred financing mechanism for reducing financial barriers to healthcare in Ghana through a social health insurance scheme.

Some key programmes and activities planned for 2017 are to adopt pragmatic strategies to increase active membership coverage of the scheme from 39 per cent in 2016 to 41 per cent of the projected population of 28.4 million. The active membership in 2017 is therefore, projected at 11.6 million.

Having completed a pilot of a claims vetting and submission application called “Claim It,” full implementation of the application is expected to take place in 2017.

“In 2017, we intend to extend the education and preparatory work for the roll out of the per capita payment module to six of the remaining regions, namely Brong Ahafo, Western, Eastern, Central, Greater Accra and Northern Regions,” said the document, which also added that “the Authority will intensify claims verifications and clinical audit of provider claims.

“In 2017, we plan to audit 15 per cent of the total facilities.”

The Authority has also planned to continue to collaborate with the MOH to review the system for pharmaceutical product supply.

Total receipts of GH¢1,237.24 were collected by the Ministry of Finance for the year ending December 31, 2016 and total payments for the year ending December 31, 2016 was GH¢1,221.23 million.

Last week, the Minority in Parliament called for the immediate withdrawal of the proposed 2017 National Health Insurance Authority (NHIA) formula from the floor of Parliament.

In the Minority’s view, the proposed NHIA Fund formula in its present state is at variance with the National Health Insurance Act, 2012, Act 852, since there has been no board approval to that effect.

Per Section 42 of Act 852, the formula is to be presented to the House after the Board of the NHIA had considered and approved it.

The proposed formula for the disbursement of the Fund was laid before Parliament on June 20, 2017, and referred to the Parliament’s Health Committee.

The Minority also said it “will not accept any referral from the National Health Insurance Authority and the Ministry of Health on same until a governing board had been properly and duly inaugurated.”

However, the Vice President, Dr. Mahamudu Bawumia, at the week-end inaugurated the newly constituted 17-member Board of Directors of the National Health Insurance Authority (NHIA) and charged them to resuscitate the scheme.

He said the scheme was at a critical stage and needed the full expertise of the board to improve.

“There is so much we want to do within a limited budget. You will be responsible for leading the policy direction and advising government so that we can take the decisions that will fundamentally improve the NHIS. [It] is struggling and we got to prevent this steady creepy towards cash and carry and resuscitate the scheme. You got to put together your minds [and] efforts so that we work in partnership to rescue this scheme, to resuscitate it, to improve it and make it benefit the masses of our people.”